Effect of Spirulina Maxima and Exercise on General Fitness and Blood Lipids in Older Adults

NCT ID: NCT04658875

Last Updated: 2024-07-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

12 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-01-17

Study Completion Date

2024-05-31

Brief Summary

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The global older adult population has grown more than any other age group, which could be explained by the decrease of birth rate and increase of life expectancy. The healthy life expectancy of older adult in Mexico is 65.8 years, and the population's life expectancy in general is 74.4 years, this means that the population meeting that age is at increased risk of developing some disease or dependence during approximately nine years of their life. For the population over 60 years, the three most frequent health conditions reported were hypertension (40%), diabetes (24.3%), and hypercholesterolemia (20.4%). In this sense, the search for a healthy lifestyle is necessary, which includes a healthy diet that includes supplementation with nutraceuticals and the daily practice of physical activity.

Regarding nutraceutical supplementation, the cyanobacterium Spirulina maxima (S. maxima) is an important source of proteins, carotenoids, phenolic compounds and polyunsaturated fatty acids which have been tested for diverse biological activities such as lipid lowering effects, however, existing studies of effects of S. maxima on body composition, physical function and blood lipid profile in humans, mainly in older adults, have a low level of evidence and absence of adequate experimental designs, so its value as a nutraceutical cannot be assured.

The effects of performing systematic physical exercise in older adults have been shown to have positive effects on body composition and blood lipid profile, so in the present study it is proposed to evaluate the synergy presented by a supplement such as S. maxima in a systematic physical exercise program on the body composition, physical function and blood lipid profile of sedentary older adults with excess weight in a randomized, double-blind, crossover, placebo controlled trial.

Detailed Description

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According to international estimations, there will be an increase in the aging population worldwide; with projections of a growth in the population older than 60 years from 900 million in 2015 to two billion in 2050. This means that the older population will move from 12% to 22% of the global population. In Mexico, in the year 2000, people aged 60 and older represented 6.8% of the total population, and an increase of 28% was expected by the year 2050; and only in Baja California State, there were 183,577 inhabitants 65 yr. old and older (Men = 46.3%, Women = 53.7%). Data from a census in Baja California's cities of Mexicali and Tijuana municipalities in 2015, showed the highest cluster of older adults above 65 yr., especially women. In Tijuana, there were 78,019 inhabitants over 65 years; with a projected population by 2020 of 101,574, and 176,134 inhabitants by 2030. The healthy life expectancy of the Mexican older adult is 65.8 years. This means that if the population's life expectancy in general is 74.4 years, the population meeting that age is at increased risk of developing some disease or dependence during approximately nine years of their life. For the population over 60 years, the three most frequent health conditions reported were hypertension (40.0%), diabetes (24.3%) and hypercholesterolemia (20.4%). These diseases affect all body systems and prevent them from carrying out daily life activities such as walking, eating, preparing or buying food, and bathing, among others. In this sense, the search for a healthy lifestyle is necessary, which includes a healthy diet that includes supplementation with nutraceuticals and the daily practice of physical activity.

Regarding supplementation with nutraceuticals, the cyanobacterium S. maxima is an important source of antioxidants, currently associated with cardiovascular protection properties. For centuries it has been cultivated and used as a nutritional supplement due to its content of amino acids and essential fatty acids, vitamin C, vitamin E, carotenoids and phycocyanins. Recently, studies on S. maxima have focused on verifying the biological activity of its components, including hypolipidemic effects. However, most studies have been conducted in animal models, with only a few studies focused on the biological effect in humans. However, most studies have been conducted in animal models, with scarce studies focused on its effects on humans. Previous researches have shown smaller adipose depots, lower blood lipid concentrations, and lower body mass gain in mice administered with a high-fat diet and S. maxima than in an high-fat diet mice control. Some studies have found a decrease in body mass, waist circumference, plasma lipid levels, inflammation, and oxidative stress in hypertensive obese patients with S. maxima supplementation (2 g for three months). However, controlled studies focused on the effect of the administration of S. maxima and a systematic exercise program in humans, have not yet been reported.

Studies on the potential effects of nutraceutical supplements are increasing in number. There have been reported the effect of 2 g/day of S. maxima supplementation on 40 hypertension subjects in a double-blind, placebo-controlled randomized trial for three months. After the intervention, they reported a significant reduction of body weight, BMI, and blood pressure in the group supplemented with S. maxima, compared with that of the placebo group. Some investigators studied the effect of Spirulina supplementation (1 g/day) during three months on the body weight, BMI, and lipid profile in patients with dyslipidemia and reported a significant decrease in total cholesterol (TC), triglycerides (TG), and cholesterol associated with low-density lipoproteins (LDL-C).

Some Spirulina compounds can reduce the macrophages infiltration into visceral fat and prevent the accumulation of liver lipids, resulting in weight reduction, specifically body fat, and there has been proved the effect of Spirulina supplementation (2 g/day) during two months on the serum lipid profile of 15 patients affected by type II diabetes mellitus, resulting in a significant reduction of TG, TC, LDL-C, and free fatty acid in blood concentrations. By means of a better-structured trial.

Many of the beneficial effects of Spirulina are attributed to its nutritional content, but its action mechanisms are poorly understood. Some authors suggest that a possible component responsible of the S. maxima hypolipidemic effect is C-phycocyanin protein, which improves the blood lipid profile. Some authors suggest that C-phycocyanin increases endogenous enzymes activity, scavenging free radicals, and downregulates cofactors in fat metabolism like adenine dinucleotide phosphate. Spirulina hypolipidemic effects can be attributed to the fact that dietary supplementation with the cyanobacteria seems to have decreased the intestinal assimilation of cholesterol, probably because Spirulina compounds bind to bile acids in the jejunum, affecting the micellar solubility of cholesterol before suppressing the cholesterol absorption. However, these studies were conducted in animal models and therefore their results cannot be extrapolated to humans, and clinical studies conducted in humans are still very scarce and appropriate clinical trials are needed to elucidate this.

Furthermore, it is known that the practice of systematic physical exercise ameliorates the risk of hypertension, diabetes and hypercholesterolemia, physical exercise of moderate intensity has the best protective effect, mainly due to physiological adaptations. Exercise has been also included as part of multicomponent interventions targeting physical function in socioeconomically vulnerable older adults in rural communities. Korean older adults (n= 187) performed a 24-week program that included group exercise, nutritional supplementation and depression management, among other components. Physical function and depression were measured before and after the intervention, with significant improvements following the intervention. Thus, appropriate exercise programs need to be implemented.

Conditions

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Overweight and Obesity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

evaluate the synergy presented by a supplement such as S. maxima in a systematic physical exercise program on the body composition, physical function and blood lipid profile of sedentary older adults with excess weight in a randomized, double-blind, crossover, placebo controlled trial.

This experimental design was chosen to eliminate inter-individual differences related to Spirulina maxima/placebo
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators
Participants' group allocations will be performed by an independent researcher, who has not any other participation during the study.

Study Groups

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Spirulina maxima supplementation and exercise group

Supplementation with Spirulina maxima (4.5 g/d) with a systematic physical exercise program during 12 weeks, then a 2 weeks washout, to finally proceed to the other treatment during 12 more weeks. During the 26 weeks of study duration every participant will have a personal isoenergetic diet.

Group Type EXPERIMENTAL

Spirulina maxima supplementation

Intervention Type DIETARY_SUPPLEMENT

Supplementation with Spirulina maxima (4.5 g/d) in capsules during 12 weeks.

Wash-out

Intervention Type OTHER

2 weeks washout period to each study subject to avoid any possible carryover effect.

Isoenergetic diet

Intervention Type OTHER

All participants will have a personal isoenergetic diet according to their height, weight, body composition and daily physical activity during 26 weeks

Systematic physical exercise program

Intervention Type OTHER

Participants in the systematic physical exercise program groups will exercise for five days a week. The physical activity program will consist of Monday to Friday chair exercises performed during 24 weeks. The approximate exercise duration will be 40 to 50 min. Each exercise session has an initial or warm-up phase (\~ 10 min), a main physical conditioning phase (\~ 25 min), and a cool-down or relaxation phase (\~ 10 min). The physical activities to select have a metabolic equivalent tasks (METs) considered as moderate, between 3.0 and 6.0 METs. Trained personnel will assist older adults to perform the activities, including articular flexibility using elastic bands, postural and proprioception exercises with materials such as rubber balls, wood sticks, and small sandbags. These activities will be selected according to the deterioration and joint stiffness that the participants could present.

Spirulina maxima supplementation

Supplementation with Spirulina maxima (4.5 g/d) without exercise program during 12 weeks, then a 2 weeks washout, to finally proceed to the other treatment during 12 more weeks. During the 26 weeks of study duration every participant will have a personal isoenergetic diet.

Group Type EXPERIMENTAL

Spirulina maxima supplementation

Intervention Type DIETARY_SUPPLEMENT

Supplementation with Spirulina maxima (4.5 g/d) in capsules during 12 weeks.

Wash-out

Intervention Type OTHER

2 weeks washout period to each study subject to avoid any possible carryover effect.

Isoenergetic diet

Intervention Type OTHER

All participants will have a personal isoenergetic diet according to their height, weight, body composition and daily physical activity during 26 weeks

Exercise group

Systematic physical exercise program during 12 weeks, then a 2 weeks washout, to finally proceed to the other treatment during 12 more weeks. During the 26 weeks of study duration every participant will have a personal isoenergetic diet.

Group Type EXPERIMENTAL

Wash-out

Intervention Type OTHER

2 weeks washout period to each study subject to avoid any possible carryover effect.

Placebo supplementation

Intervention Type OTHER

Supplementation with placebo (4.5 g/d) in capsules during 12 weeks.

Isoenergetic diet

Intervention Type OTHER

All participants will have a personal isoenergetic diet according to their height, weight, body composition and daily physical activity during 26 weeks

Systematic physical exercise program

Intervention Type OTHER

Participants in the systematic physical exercise program groups will exercise for five days a week. The physical activity program will consist of Monday to Friday chair exercises performed during 24 weeks. The approximate exercise duration will be 40 to 50 min. Each exercise session has an initial or warm-up phase (\~ 10 min), a main physical conditioning phase (\~ 25 min), and a cool-down or relaxation phase (\~ 10 min). The physical activities to select have a metabolic equivalent tasks (METs) considered as moderate, between 3.0 and 6.0 METs. Trained personnel will assist older adults to perform the activities, including articular flexibility using elastic bands, postural and proprioception exercises with materials such as rubber balls, wood sticks, and small sandbags. These activities will be selected according to the deterioration and joint stiffness that the participants could present.

Control group

No systematic physical exercise program and No supplementation during 12 weeks, then a 2 weeks washout, to finally proceed to the other treatment during 12 more weeks. During the 26 weeks of study duration every participant will have a personal isoenergetic diet.

Group Type ACTIVE_COMPARATOR

Wash-out

Intervention Type OTHER

2 weeks washout period to each study subject to avoid any possible carryover effect.

Placebo supplementation

Intervention Type OTHER

Supplementation with placebo (4.5 g/d) in capsules during 12 weeks.

Isoenergetic diet

Intervention Type OTHER

All participants will have a personal isoenergetic diet according to their height, weight, body composition and daily physical activity during 26 weeks

Interventions

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Spirulina maxima supplementation

Supplementation with Spirulina maxima (4.5 g/d) in capsules during 12 weeks.

Intervention Type DIETARY_SUPPLEMENT

Wash-out

2 weeks washout period to each study subject to avoid any possible carryover effect.

Intervention Type OTHER

Placebo supplementation

Supplementation with placebo (4.5 g/d) in capsules during 12 weeks.

Intervention Type OTHER

Isoenergetic diet

All participants will have a personal isoenergetic diet according to their height, weight, body composition and daily physical activity during 26 weeks

Intervention Type OTHER

Systematic physical exercise program

Participants in the systematic physical exercise program groups will exercise for five days a week. The physical activity program will consist of Monday to Friday chair exercises performed during 24 weeks. The approximate exercise duration will be 40 to 50 min. Each exercise session has an initial or warm-up phase (\~ 10 min), a main physical conditioning phase (\~ 25 min), and a cool-down or relaxation phase (\~ 10 min). The physical activities to select have a metabolic equivalent tasks (METs) considered as moderate, between 3.0 and 6.0 METs. Trained personnel will assist older adults to perform the activities, including articular flexibility using elastic bands, postural and proprioception exercises with materials such as rubber balls, wood sticks, and small sandbags. These activities will be selected according to the deterioration and joint stiffness that the participants could present.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Sedentary older adults
* BMI over 25 kg/m2
* Volunteered to participate

Exclusion Criteria

* Presenting a chronical disease
* Drinking alcohol
* Taking diet supplements
* Presenting an impediment to practicing regular physical exercise

Elimination Criteria:

* Attendance by the subject of \< 80% to the physical exercise sessions
Minimum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Universidad Autonoma de Baja California

OTHER

Sponsor Role lead

Responsible Party

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Marco Antonio HernĂ¡ndez Lepe

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Medical and Psychology School

Tijuana, California, Mexico

Site Status

Countries

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Mexico

References

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Other Identifiers

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998/2020-2

Identifier Type: -

Identifier Source: org_study_id

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